There are marked differences between countries with regard to reimbursement decision-making, yet few studies have tried to understand this process and its consequences by a detailed analysis of the local context and decision-making structure. This article describes reimbursement decision-making and subsequent prescribing patterns of new pharmaceuticals by means of a case study on glitazones in treatment of type 2 diabetes mellitus patients in Denmark. The study shows that institutional arrangements, providing the context in which evidence is used, are highly important (...) for understanding the reimbursement decision-making process. In particular the Danish Medicines Agency (DMA) has shaped the decision to reimburse glitazones on the basis of physician-mediated requests of individual patients. Relatively few patients have been prescribed glitazones since their introduction in 2000, suggesting that individual reimbursement may be an effective instrument in controlling overall expenditure of selected pharmaceuticals, although in the case of glitazones this has likely been achieved at the expense of equality in access to the products. The discussion focuses on the generalizability of the findings to both other pharmaceuticals in the individual reimbursement scheme in Denmark, and to other countries that are trying to balance the need to control overall pharmaceutical care expenditure with the need to secure equality in access to new drugs with therapeutic added value. (shrink)

Philosopher Judith Butler has influenced how people talk about vulnerable bodies and sees vulnerability as universal, existential, and relational. Being vulnerable is part of the human condition. The main theoretical areas that run across Butler’s work; power, knowledge and subjectivity, performativity, and ethics—are of particular relevance to nursing practice. This review aims to explore how Butler’s theoretical work is reflected in research literature within a nursing context. We conducted a scoping review guided by Arksey and O’Malley’s methodological framework. A systematic (...) literature search of CINAHL (EBSCOhost), MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid), and Web of Science identified 15 papers. Butler’s theoretical work was applied at an individual and social level in research literature within a nursing context. Nurses need to reflect on their clinical practice and role as health professionals in relation to power and performativity in encounters with patients who are marginalized. Nurses’ working conditions, recognition, and understanding are strongly influenced by society, and calling nurses heroes undermines their capacity to challenge and resist the hero identity. The healthcare system’s impact on patient-nurse encounters challenges patients’ and nurses’ subjectivity, performativity, and power relations. The review allowed us to describe how Butler’s theoretical work can facilitate a reflection on nursing practice which is a prerequisite for caring, ethical relationships, and working conditions within a nursing context. Butler’s concepts can provide useful perspectives on how nurses understand, communicate with, and care for patients, as well as a nuanced understanding of the nursing role and power relations and structures. (shrink)

The aim of this study was to compare the acute effects of performing a lower body resistance training program in one long or two shorter sessions in 1 day on training volume and affective measures. Employing a randomized-crossover design, 23 resistance-trained women performed two training days consisting of one long or two short sessions separated by 3.5–5 h. Each training day was separated by 4-6 days and consisted of three sets to failure for six exercises. Training volume were recorded during (...) the sessions. Rating of perceived exertion for effort, rating of perceived exertion for discomfort, session displeasure/pleasure and exercise enjoyment were measured 10 min after each session. Participants also completed a readiness to train questionnaire, 24 h after each session, and which training protocol they preferred, 48 h after the last session. The long session led to higher RPE, RPD and sPDF compared to the short sessions. There was no difference in EES. The short sessions had 3% higher training volume than the long session. There were no differences in perceived readiness to train 24 h after the sessions. Twenty-two participants preferred the long session, while one preferred the short sessions. In conclusion, performing a longer, lower body, resistance training session led to greater perceptions of effort, discomfort and session pleasure than splitting the same program into two shorter sessions among resistance-trained women. However, two shorter sessions led to a greater training volume. (shrink)

A core value of Judaism is leading an ethical life. The Talmud, an authoritative source on Jewish law and tradition, has a number of discussions that deal with honesty in business and decision-making. One motive that can cause individuals to be unscrupulous is the presence of a conflict of interest. This paper will define, discuss, and review five Talmudic concepts relevant to conflict of interest. They are (1) Nogea B’Davar (being an interested party), (2) V’hiyitem N’keyim (behaving to ensure that (...) one is above suspicion) (3) Lifnei Iver (placing a stumbling block before the blind), (4) Shokhad (accepting a bribe), and (5) Geneivat Da’at (deception and undeserved goodwill). Case examples will be used to apply these Talmudic principles to contemporary business practice. This will include discussion of these Talmudic concepts as it applies to specific contemporary business examples relevant to the boardroom, accounting firms, investment banking, politics, and government. It may be impossible to eliminate all conflicts of interest. However, knowledge and awareness of these Talmudic principles can help individuals in business settings better address the ethical issues that they confront. (shrink)

Originally published in 1936, this book presents the ancient Greek text of the paraphrases and quotations of Zeno's philosophical arguments, together with a facing-page English translation and editorial commentary. Detailed notes are incorporated throughout and a bibliography is also included. This book will be of value to anyone with an interest in Zeno and ancient philosophy.

This paper focuses on abduction as explicit or readily formulatable inference to possible explanatory hypotheses--as contrasted with inference to conceptual innovations or abductive logic as a cycle of hypotheses, deduction of consequences and inductive testing. Inference to an explanation is often a matter of projection or extrapolation of elements of accepted theory for the solution of outstanding problems in particular domains of inquiry. I say "projections or extrapolation" of accepted theory, but I mean to point to something broader and suggest (...) how elements of accepted theory constrain emergent models and plausible inferences to explanations--in a quasi-rationalist fashion. I draw on illustrations from quantum gravity below just because there is so little direct evidence available in the field. It is in such cases that Peirce's discussions of abductive inference provide the most plausible support for the idea of a logic of abduction--as inference to readily formulatable explanatory hypotheses. The possible need for conceptual innovation points to the limits on the possibility of a logic of abduction of a more rationalistic character--selecting uniquely superior explanations. Abduction conceived as a repeated cycle of inquiry also points to limits on our expectations for an abductive logic. My chief point is that the character of inference to an explanation, viewed below as embedded within arguments from analogy, is so little compelling, as a matter of logical form alone, that there will always be a pluralism of plausible alternatives among untested hypotheses and inferences to them--calling for some comparative evaluation. This point leads on to some consideration of the virtues of hypotheses--as a description of the range of this pluralism. (shrink)

1 – Institute for Frontier Areas of Psychology and Mental Health, Wilhelmstr. 3a, 79098 Freiburg, Germany 2 – Parmenides Center, Via Mellini 26-28, 57031 Capoliveri, Italy 3 – Department of Ophtalmology, University of Freiburg, Killianstr. 5, 79106 Freiburg, Germany 4 – Institute of Physics, University of Freiburg, Hermann- Herder -Str. 3, 79104 Freiburg, GermanyThe “Necker-Zeno model”, a model for bistable perception inspired by the quantum Zeno effect, was previously used to relate three basic time scales of cognitive relevance to one (...) another in a quantitative manner. In this paper, the model predictions are compared with experimental results obtained under discontinuous presentation of an ambiguous stimulus. In addition to earlier results for long inter-stimulus intervals, we show that the reversal dynamics according to the Necker-Zeno model is also in agreement with new results for short inter-stimulus intervals. Moreover, we refine the model in such a way that it accounts for the distribution of “dwell times”. Finally, we indicate applications concerning the modification of cognitive time scales under conditions of psychopathological impairments and meditationinduced modes of awareness. ∗Address correspondence to this author at the Theory Division of the Institute for Frontier Areas of Psychology, Wilhelmstr. 3a, D–79098 Freiburg, Germany; E-mail: [email protected]. (shrink)

The development of transplantation technology increasingly places before society a multitude of diverse, complex ethical and legal problems. The subject is the more complex because of the various divergent interests involved. There are the interests of the donor of organs, who has a right to protection of his legal position, and those of the patient in need of an often lifesaving organ. There are also the interests of the donor’s relatives, after his death, and those of the transplantation surgeons. The (...) international dimension of transplantation technology makes the picture even more complicated. Though this article is devoted to the European situation, the problems are similar all over the world. (shrink)

Background The consistency of codes governing disclosure of terminal illness to patients and families in Islamic countries has not been studied until now. Objectives To review available codes on disclosure of terminal illness in Islamic countries. Data source and extraction Data were extracted through searches on Google and PubMed. Codes related to disclosure of terminal illness to patients or families were abstracted, and then classified independently by the three authors. Data synthesis Codes for 14 Islamic countries were located. Five codes (...) were silent regarding informing the patient, seven allowed concealment, one mandated disclosure and one prohibited disclosure. Five codes were silent regarding informing the family, four allowed disclosure and five mandated/recommended disclosure. The Islamic Organization for Medical Sciences code was silent on both issues. Conclusion Codes regarding disclosure of terminal illness to patients and families differed markedly among Islamic countries. They were silent in one-third of the codes, and tended to favour a paternalistic/utilitarian, family-centred approach over an autonomous, patient-centred approach. (shrink)

This book covers the author's conception of God aside from any religion. He does not come from a religious view in order to transmit the truest conception of God that he is capable of because any religion, whatever it might be, always claims God for itself in an exclusionary fashion. In other words, you must be a follower of the chosen faith before God will accept you into his kingdom. Wells rejects this view. Any man or woman who accepts God's (...) love as one person connecting to their own creator, is fine. An intermediary, despite what they might crow from whatever pulpits they use, is not necessary. We are all God's children. We are all seeking the same God, so to be dogmatic within a certain exclusionary faith is small-minded and petty. If you want to grow up, spiritually, then this book is for you. (shrink)

Open peer commentary on the article “Religion: A Radical-Constructivist Perspective” by Andreas Quale. Upshot: Quale offers a way of categorizing religious discourse based on radical constructivism. This commentary raises questions about the inter-relation of cognitive and non-cognitive knowledge, the role of testimony in learning about religion, and whether knowledge and belief have different roles in cognitive and non-cognitive knowledge, and suggests that Quale’s analysis opens a tolerant perspective on religious discourse.